What Is Atelectasis?

If you’ve recently had a chest scan, reading your own results may raise more questions than answers. Many radiology reports use the word “atelectasis,” a phrase one expert says looks scarier than it usually is.

“It’s a pretty common finding on a chest scan, such as an x-ray, CT scan, or MRI. It’s just an observation that areas of the lung are not completely expanded with air on the imaging, perhaps because an airway is plugged, or maybe you just didn’t take a deep enough breath,” says Yolonda Colson, MD, PhD, a Mass General Cancer Center thoracic surgeon and chief of the Division of Thoracic Surgery at Massachusetts General Hospital. Dr. Colson also cares for patients at Wentworth-Douglass Hospital.

In most cases, atelectasis disappears by the next scan.

Atelectasis symptoms

Atelectasis (pronounced at-uh-LEK-tuh-sis) usually doesn’t cause any symptoms. It’s usually found on a chest scan that was performed for some other reason.

When people have a large amount of atelectasis, they may experience symptoms such as:

• Coughing

• Difficulty breathing

• Low-grade fever

• Wheezing

Atelectasis on a chest scan

When a radiologist looks at images from a chest scan, they can see any areas of the lungs that aren’t fully expanded by air. They note this in the report as atelectasis or an atelectatic band.

Atelectasis is common after surgery of any kind — not just lung surgery — when a person has pain and can’t take deep breaths. It also may occur due to scar tissue in the lung after lung surgery, or following a chest injury or inhalation of a foreign object. In rare cases, atelectasis can be related to serious respiratory conditions, such as lung cancer or cystic fibrosis.

If a radiologist notes atelectasis on a chest scan, your doctor or surgeon will review the information. They may repeat the scan in a few months to see whether the lung is still atelectatic later. 

Atelectasis and lung cancer

If atelectasis shows up repeatedly in a specific area of the lung, it might indicate a blockage. This may be caused by secretions or sometimes a tumor, which may require additional tests.

“The airway is like a giant tree with branches. If we’re seeing consistent atelectasis, particularly in a particular branch, we need to look at that airway to understand why the lung is not expanding at all in that area. Is there something preventing air from getting there?” Dr. Colson explains.

Your doctor may perform a bronchoscopy, inserting a thin tube called a bronchoscope through your nose or mouth and into the lungs. The tube has a light and camera on the end, which projects images from inside your airway onto a screen. The doctor can then see if there’s any sign of disease or a blockage. If there is suspicious tissue, the doctor can take a small sample and test it for cancerous cells (biopsy).

Atelectasis treatment

Treatment for atelectasis depends on the cause. Small areas of atelectasis at the edges of the lung require no treatment other than taking deeper breaths. However, if cancer is blocking an airway, then treatment focuses on removing the tumor.

Atelectasis with cystic fibrosis is usually related to blockages caused by mucus. Treatments may involve antibiotics or chest physiotherapy, also called airway clearance therapy (ACT). In patients recovering from surgery, the focus is clearing mucus and fluids from the lungs.

“In patients recovering from surgery, we work really hard to get them up and moving, practicing deep breathing, coughing to clear secretions, and using tools to get secretions out of the lungs,” Dr. Colson says. “There are all sorts of ways we try to get them to clear their lungs so that mucus and fluids don’t sit there, which can lead to pneumonia.”

One popular tool is an incentive spirometer, which helps measure how deep your breaths are. Your doctor may perform a bronchoscopy to suction mucus and fluids from the lungs as you recover from surgery.

Dr. Colson encourages people not to be overly concerned about seeing atelectasis on a radiology report.

“To patients, it may seem like a big, horrible word that sounds like you have a major condition. It’s important for your health care providers to know if you have atelectasis, but it’s usually not significant, and you shouldn’t be alarmed,” she explains. “Most of the time, you can think of atelectasis similar to a balloon that isn’t completely inflated, and all you have to do is to relax and take a deep breath to fix the problem.”